Bone metastases as the first manifestation of thyroid carci- noma are extremely rare. Interestingly, evaluation at appropriate initials and proper treatment will lead to satisfactory long-term survival. We report here on two such cases; the patients presented with back pain and fine needle aspiration cytology of spine lesion revealed a metastatic carcinoma. A wide excision of the bone lesion was carried out and the histopathology was consistent with features of metastatic carcinoma of the thyroid. The management of thyroid carcinoma and the subsequent bone metastases is reviewed and the controversial points are highlighted.